Prior Authorization Associates (5-Jan-26)

ECLAT Health Solutions; Hyderabad; On-site; INR 400,000 - 600,000; Full time

Job summary

Eclat-Health-Solutions-4 is seeking a Prior Authorization Associate in Hyderabad, India. This role focuses on securing insurance approvals for medical services and involves reviewing patient records and verifying insurance.

The successful candidate will manage authorization requests, handle denials, and fulfill administrative tasks linked to payer policies. Strong knowledge of medical terminology and organizational skills are essential for this role.

Qualifications

• Strong understanding of insurance approval processes for medical services.
• Experience in handling denied authorization requests and appeals.
• Competence in data entry and patient record management.

Responsibilities

• Prepare and submit detailed authorization requests with necessary information.
• Examine patient charts to ensure treatments meet payer criteria.
• Handle rejected authorizations and file appeals as necessary.

Skills

Knowledge of medical terminology/coding

Problem-solving

Organizational skills

Ability to multitask

Job description

Prior Authorization Associates (5-Jan-26)

1-4

Full-Time

A Prior Authorization (PA) job involves securing insurance approval for medical services, medications, or equipment before they're provided, requiring review of patient records, verifying insurance, submitting detailed requests, tracking approvals/denials, appealing rejections, and communicating with providers and patients, ensuring timely patient care and revenue cycle efficiency. Key duties include data entry, follow-ups, ensuring medical necessity documentation, and handling administrative tasks related to payer policies.

• Request Submission: Prepare and submit detailed authorization requests with all necessary clinical and demographic info to payers.
• Documentation Review: Examine patient charts to ensure treatments meet payer criteria and medical necessity guidelines.
• Denial Management: Handle rejected authorizations, file appeals, and work to resolve issues.
• Knowledge of medical terminology/coding (often preferred)
• Problem-solving
• Organizational skills and ability to multitask